ABSTRACT
This chapter explores the content and meanings of delusions and hallucinations and the details of the patients’ past history. This perspective is in contrast to much of current psychoanalytic practice, where minute examination of the transference and countertransference takes precedence over the investigation of past history. W. R. Bion recommended that the analyst should relinquish “memory and desire”, an opinion that has sometimes caused confusion in those therapists who have taken it to mean that they should forget about the patient’s past history during the therapeutic sessions. Idealizing psychotherapy as a panacea for psychotic disturbance could lead therapists to underestimate the difficulty in helping chronic and fragmented patients and thus to disappointment and disillusionment. Dilution of psychoanalytic knowledge could be misleading and harmful to the therapists and to the principles of psychoanalysis. It is usually the nursing staffs, who know the hospitalized psychiatric patient best, and their psychotherapeutic potential has been recognized in some centres and their opportunities for further training promoted.
